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Anthony Bray MD
Anthony Bray MD, Physician
Category: Dermatology
Satisfied Customers: 10337
Experience:  14 years of Family Practice Experience including most dermatology problems
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I had a little scabby spot on the top of my nose that comes

Customer Question

I had a little scabby spot on the top of my nose that comes in the summer usually here in Florida. I see my Derm regularly and it wasn't there in May. I went in yesterday and he checked it and said it was Actnic Keratosis and froze it. Said that it wasn't
worth biopsing. Is this safe procedure? They froze this spot off 3 years ago also and it just came back
Submitted: 1 year ago.
Category: Dermatology
Expert:  Anthony Bray MD replied 1 year ago.

Hello!

Yes the freeze treatment is standard for an actic keratosis. It is safe . That is typical treatment for this type skin lesion. If it should recur again in same spot then I think biopsy would be warranted.

I hope that this information is helpful for you Let me know if you have further questions.I will be happy to get back with you If my answers have been helpful and to your satisfaction then please remember to leave positive feedback Thank you and Best Regards,

Anthony Bray MD

Customer: replied 1 year ago.
Ok, well this is the 2nd time it has come up in the last 3-4 years. Is this more concerning? Why would he just freeze it again?
Can squamous cell be treated by freezing?
Customer: replied 1 year ago.
this was before freezing...
Expert:  Anthony Bray MD replied 1 year ago.

Hello again,

Well since it is a recurrence I would have preferred to biopsy but it is more probably an acting keratosis . Yes a limited squamous cell cancer would also be most often eradicated by the cryotherapy . So I would watch how it heals . If there remains any question of it looking abnormal or suspicious then a biopsy would be advisable as next step.

I hope that this is helpful Let me know if you have further questions or concerns.

Best Regards,

Anthony Bray MD

Customer: replied 1 year ago.
Ok. Are the chances of this being something scary and life threatening small? Did you see the before photo.
I want to add, this goes away completely in the non sun times. Generally if Im out of the sun for a few weeks, it isn't there.
Customer: replied 1 year ago.
Ok, so if this was a limited squamous cell, then the freezing he did should be enough?.. its on the bridge of my nose.
Expert:  Anthony Bray MD replied 1 year ago.

Hello again,

Ok I just now saw your pictures. It does not APPEAR to me to be a squamous cell carcinoma. (I must qualify that to admit I do not have any microscopic vision of course) it looks consistent to me with Sun caused damage consistent with an actinic keratosis as well You have some telangiectasia on the end of your nose as well. These are not a concern. Based on your appearance it does not look to be a concern So much for squamous cell carcinoma.Of such should develop then these are readily treated with excision. It is not any life threatening type level problem unless progressive and ignored .

I hope that this is helpful Let me know if you have further concerns.Best regards,

Anthony Bray MD.

Customer: replied 1 year ago.
Ok, so if im on top of this should there be a change, it can be a easy fix? maybe the cryo would kill the bad cells, if there were any??What is telangiectasia?
Customer: replied 1 year ago.
Ok I googled that. Nothing concerning.As for my nose yes, the doctor felt it and looked at it. It isn't thick and it isn't hard. it was soft, just there. It wasn't like a thick lesion so hopefully that means it was nothing.
Living in south florida, we live on the boat! I wear great sun protection and always in a hat and long sleeve shirts. Too many years of boating...
Expert:  Anthony Bray MD replied 1 year ago.

Hello again,

Yes...as long as you stay on top of it you will be fine. The cryo should kill bad cells - Yes to that as well. Right --the telangiectasia is simply dilated blood vessels. I agree that you need to watch your Sun protection of course.

I hope that this helps to put your mind at ease. Let me know if you have anything further.

Take Care!

Anthony Bray MD

Customer: replied 1 year ago.
Thanks. Ok. And would squamous cell come and go or would it just get worse? This wasn't an actual scab or anything. Just a little spot.
I'm worried that he froze it and that it will spread now or somethjng if it is squamous cell. I asked him about squamous and he said even if he biopsied it and there was a trace of it as it is small, the pathologist is really a judgement call and I would have the same procedure. Just multiple freezes to ensure the cells died.I just don't want to be neglectful.
Expert:  Anthony Bray MD replied 1 year ago.

Hello again,

No a squamous cell would not come and go but would be expected to behave in an abnormal and gradually progressive fashion..

The cryo treatment WOULD NOT cause that to spread if you had any such cells.

I think a small isolated lesion is fine to do cryo as your dermatologist did...

I understand your concern to not be neglectful and agree that you do want to watch that area but the treatment would also take out isolated and small nidus of squamous cell if that existed..

If squamous cell should be more suspect then an excision is prefered to examine the margin of the biopsy to ensure they are clear.

The procedure as you had is less disfiguring in its potential and that probably weighed on the choice as well.

I think the doctor that did your cryo procedure would have opted for biopsy if he had thought that a squamous cell was likley...

I think the decision to freeze was both the assesment that it fit more with actinic keratosis and the lower wound area to your face and better healing..

So I think that you will be fine her is the bot***** *****ne.

I hope that this is helpful for you. Let me know if you have further questions. I will be happy to get back with you! Best Regards,

Anthony Bray MD